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Delirium and drugs

MONTREAL, CANADA. Delirium is an acute brain disorder manifesting itself by illusions, disorientation, hallucinations or extreme excitement. Delirium is particularly prevalent in elderly hospitalized patients where the incidence rate may be as high as 26 per cent. Researchers at the Montreal General Hospital now report that many common drugs can increase the severity of delirium. Their study involved 278 elderly hospitalized patients who had been or were suffering from delirium. The researchers kept track of the drugs given to the patients and then assessed the severity of their delirium on the following day. Patients received an average of 7.7 different drugs every day of which 1.4 was known to affect the parasympathetic nervous system (anticholinergic medications). The researchers found a strong correlation between the ingestion of anticholinergic drugs and the worsening of delirium. Among the worst offenders were:

  • dimenhydrinate (Gravol)
  • thioridazine (Mellaril)
  • haloperidol (Haldol)
  • ranitidine (Zantac)
  • acetaminophen/codeine phosphate (Empracet)
  • pethidine hydrochloride (Demerol)
  • paroxetine (Paxil)

Han, Ling, et al. Use of medications with anticholinergic effect predicts clinical severity of delirium symptoms in older medical inpatients. Archives of internal Medicine, Vol. 161, April 23, 2001, pp. 1099- 1105

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